Gemayel Gino, Mootoosamy Parmeseeven, Murith Nicolas, Kalangos Afksendiyos
Department of Cardiovascular Surgery, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Department of Cardiovascular Surgery, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Ann Vasc Surg. 2016 May;33:230.e15-8. doi: 10.1016/j.avsg.2015.11.034. Epub 2016 Mar 9.
To report the case of a rapidly growing aortic false aneurysm because of Q fever infection that was managed by embolization.
An 80-year-old man was admitted to our unit for an aortic false aneurysm from a chronic Q fever infection. During his stay, the aneurysm showed rapid progression necessitating urgent treatment. The patient was unfit for surgical repair; moreover, the location of the aneurysm at the level of the superior mesenteric artery prohibited the use of an endovascular graft. He was managed by coiling of the aneurysmal cavity with multiple detachable coils after positioning of a bare aortic stent to lock the coils and prevent their migration into the aortic lumen. The false aneurysm was successfully thrombosed with no complications. The patient was then put on doxycycline and hydroxychloroquine to target Coxiella burnetii.
Aortic false aneurysm coiling is feasible in cases where an endograft is not possible or an open repair is contraindicated. The use of a bare metal stent may help as a barrier to prevent the coils from migrating into the aneurysm and thus avoiding embolization into the systemic circulation.
报告一例因Q热感染导致的快速生长的主动脉假性动脉瘤，通过栓塞治疗的病例。
一名80岁男性因慢性Q热感染导致主动脉假性动脉瘤入住我院。住院期间，动脉瘤进展迅速，需要紧急治疗。患者不适合手术修复；此外，动脉瘤位于肠系膜上动脉水平，无法使用血管内移植物。在放置裸主动脉支架以锁定线圈并防止其迁移到主动脉腔内后，通过使用多个可脱卸线圈对动脉瘤腔进行栓塞治疗。假性动脉瘤成功血栓形成，无并发症。然后患者接受强力霉素和羟氯喹治疗以针对伯氏考克斯体。
在无法使用血管内移植物或开放修复禁忌的情况下，主动脉假性动脉瘤栓塞是可行的。使用裸金属支架可能有助于作为屏障，防止线圈迁移到动脉瘤中，从而避免栓塞进入体循环。
